1497822944 NPI number — MR. LOUIS FRANKLIN AHALT JR. MSW

Table of content: MR. LOUIS FRANKLIN AHALT JR. MSW (NPI 1497822944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497822944 NPI number — MR. LOUIS FRANKLIN AHALT JR. MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHALT
Provider First Name:
LOUIS
Provider Middle Name:
FRANKLIN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
MSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497822944
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/27/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1140 OPAL CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAGERSTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21740-5940
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-790-1560
Provider Business Mailing Address Fax Number:
301-790-1666

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1140 OPAL CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAGERSTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21740-5940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-790-1560
Provider Business Practice Location Address Fax Number:
301-790-1666
Provider Enumeration Date:
11/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  04986 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 002860 . This is a "VALUE OPTIONS PROVIDER NO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 325085 . This is a "M.D. IPA PIN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 100027640001 . This is a "APS HEALTHCARE PIN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: R036 0001 . This is a "CAREFIRST BCBS FEP PIN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7680030 . This is a "AETNA PIN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com